Back in 2015, Reuben gave an amazing talk on the subject of ketamine and its uses in Emergency Medicine at the SMACC Chicago conference. It has a lot of fun slides too!

I recommend listening to Reuben’s SMACC talk first, and then listen to this podcast episode and refer to the show notes.

This talk got pretty in depth and long so I broke it up into 3 separate episodes.

Today’s episode is Part 1, an Introduction to Ketamine. Part 2 and 3 will cover the applications of Ketamine in the ED in detail.

Ketamine

Ketamine is traditionally used as an anesthetic in the operating rooms. However, in many ED units, it’s commonly used as a procedural sedation agent and an induction agent for intubation. We will be talking about off-label uses including low dose ketamine for analgesia. Take note, you should know your institution’s policies. If you don’t have one, maybe you can develop some!

Safety Alert

Must know how to monitor patients who receive ketamine for periods of apnea, psychomimetic disturbances, hypertension, tachycardia.

Must have an airway capable provider at the bedside who can quickly intubate if necessary

Weight based dosing on all patients.

Keep 1 concentration of Ketamine in your ED

2 different concentrations: 100mg/mL and 50mg/mL

I like the 50mg/mL concentration and prefer the single-use vials

It’s easier to push ketamine slower with the weaker concentration. Otherwise, you can dilute the ketamine.